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Rescue Strategy in Cardiogenic Shock: Emergency Transcatheter Aortic Valve Implantation for Failed Bioprosthetic
Ricardas Kundelis1, Vilhelmas Bajoras1,2, Sigitas Čėsna1,2
1Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Background:
Transcatheter aortic valve implantation (TAVI) has emerged as an essential therapeutic intervention for patients with severe aortic valve disease, providing a less invasive alternative to traditional surgery, particularly in high-risk individuals. TAVI is also increasingly utilized as a valve-in-valve strategy in cases of a bioprosthetic valve failure. However, data on the efficacy of TAVI in the context of a hemodynamic collapse remain limited.
Methods:
This report represents a young, high-risk patient with a failed bioprosthetic valve and cardiogenic shock treated successfully with TAVI.
Results:
Emergency TAVI using a Medtronic Evolut Pro+ device achieved rapid hemodynamic stabilization and favorable post-procedural clinical and functional outcomes. Intermittent complete atrioventricular block necessitated the implantation of a permanent pacemaker.
Conclusions:
This case highlights the potential of TAVI as a safe and effective intervention in critical clinical scenarios. Emergency TAVI is a viable therapeutic intervention for patients with failed surgical bioprostheses presenting with cardiogenic shock.
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